Individual provider Active NPI

Pam Ladetto, MSW, LCSWA

  • Clinical Social Worker
  • Greensboro, NC
National Provider Identifier
1205179629
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
COO9724 Issued in NC
Practice address
430 Battleground Ave
Greensboro, NC 27401-2104
Phone
(336) 337-5469
NPI assigned
Apr 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X COO9724 NC Primary

Addresses

Primary practice location

430 Battleground Ave
Greensboro, NC 27401-2104

Mailing address

2100 W Cornwallis Dr Ste O
Greensboro, NC 27408-7015
Phone (336) 337-5469

Other identifiers 2

IdentifierTypeStateIssuer
COO9724OtherNCNC SOCIAL WORK CERTIFICATION AND LICENSURE
12625110OtherNCCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
COO9724NCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1205179629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W CORNWALLIS DR STE O",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087015",
            "telephone_number": "336-337-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 BATTLEGROUND AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012104",
            "telephone_number": "336-337-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADETTO",
        "first_name": "PAM",
        "credential": "MSW, LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "COO9724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC SOCIAL WORK CERTIFICATION AND LICENSURE",
            "identifier": "COO9724",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12625110",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.